Hospitals across the country have begun to implement emergency procedures in anticipation of the departure of nearly 1,000 medical residents on Sunday, when the doctors' resignation letters are set to take effect. Haaretz has learned that Meir Hospital in Kfar Sava has already canceled appointments at its outpatient clinic.

In an unprecedented move, the Health Ministry has circulated a statement imposing responsibility for the health system's operation on hospital directors, who are believed by some to have given support to the disgruntled residents at the start of the protest. The ministry is demanding that hospitals take immediate steps to prepare for the mass resignation Sunday, including the cancelation of vacations and training leaves scheduled by doctors, as well as the postponement of non-essential treatment procedures, and the allocation of administrative personnel to help in departments that suffer from a serious lack of manpower.

Doctors protesting this month.Alon Ron

Health Ministry officials have consulted with the government attorney general and are arguing that the collective resignation is illegal. Dr. Hezy Levy, head of the Health Ministry's medical authority, sent a letter to protesting residents yesterday announcing that expert legal opinion confirms that the resignations lack validity.

As far as the Health Ministry is concerned, all the protesting doctors who submitted resignation letters must still be viewed as regular workers. The Health Ministry said that heads of hospital departments must continue to assign these workers to all their normal duties on Sunday and thereafter.

Residents who do not show up to work must be viewed as absentee workers, the Health Ministry argues, not as employees who have resigned; the residents will be considered to be in dereliction of work duties.

On Tuesday, state prosecutors petitioned the High Court and delivered a brief demanding that action be taken to deal with the crisis in the public health system. The High Court nullified the petition, noting that a mediation procedure had already culminated last week in the signing of an agreement between the Israel Medical Association and the Finance Ministry. The High Court ruled that there is no reason to consider another brief on the doctors' protests.

Finance Ministry officials conferred Wednesday with their counterparts at the Justice Ministry, and considered the possibility of submitting the brief to a labor court instead. The goal of the brief would be to have the strike declared illegal, and to have restraining orders issued to doctors who are absent from work next week.

Officials at the Justice Ministry said last night that "at this stage we are not responding to questions on this matter."

On Wednesday, representatives of the young physicians union that represents the residents rejected the claim that the resignation is illegal. In a letter sent to the Health Ministry's medical authority, the union contended that "the resignation of each of these young doctors is a personal act, and each person's signature came after an independent decision reached by each of the residents."

The directives circulated on Wednesday to hospital directors by the Health Ministry's medical authority are unprecedented in their severity. Due to the residents' anticipated absence, vacation leaves that had been granted to doctors at several hospitals have been canceled until further notice. The order regarding vacation cancelations, the circular clarifies, "applies to annual leaves granted for the purpose of preparation for examinations."

The Health Ministry will also take steps reinforce available staff in hospitals by obtaining Israel Defense Forces reserve duty releases for residents who have not resigned.

Hospital directors have been instructed to contact residents who do not come to work on Sunday, and to clarify the reason for their absence. The hospitals are to report to the Health Ministry about the scale of the absenteeism so that the ministry can consider appropriate sanctions against the missing doctors.

Magen David Adom medical workers will be instructed not to transport or direct patients to hospitals where large numbers of residents are absent. The Health Ministry is likely to issue a call directly to the public, urging people not to go to emergency rooms at hospitals with high levels of resident absenteeism.

The Health Ministry has instructed hospitals not to cancel essential medical procedures, including operations for cancer patients, chemotherapy procedures, dialysis, operations for young people, and procedures for which patients have waited longer than three months.

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